Toward a skin dose-area metric predictive of moist desquamation using in-vivo skin dosimetry and skin assessments

Background and Purpose: Moist Desquamation (MD) is a concerning acute side effect of radiation therapy for breast cancer, often seen in skin folds patients having large or pendulous breasts. In-vivo dosimetry, clinical assessments patient reported reactions were used to determine relationship between dose-area metrics the development MD, lend insight into tolerances possibly guide future treatment planning dose constraints.Materials Methods: Skin was measured using GafChromicTM film on inner surface an early prototype carbon-fiber accessory support remove inframammary fold 20 at high risk developing MD undergoing adjuvant whole radiotherapy. Prescribed doses 42.5 Gray (Gy) 16 fractions 50 Gy 25 6 to15 MV x-rays. To account fraction size differences, analysis performed equivalent 2 α/β = 11 (EQD211). assessed out weeks post radiotherapy by trained therapists outcome questionnaire.Results: Statistically significant differences areas receiving 30 48 (EQD211) observed who did not develop infra-mammary area. Patients EQD211 maximum ≤ 46Gy ≥38Gy 50cm2 their MD.Conclusions: The findings this study offer toxicity irradiated up Gy. Potential constraints test studies prevent are suggested.